This study examines how different types of host-guest interaction relate to tourists' value co-creation intention in urban tourism and whether artificial intelligence technology stimuli moderate these relationships. Grounded theory was used to identify the main constructs and relationships. Survey data were then analyzed using partial least squares structural equation modeling, and fuzzy-set qualitative comparative analysis was conducted to identify configurations associated with high value co-creation intention. The results showed that tourist-government interaction and tourist-resident interaction were positively related to tourist empowerment, and tourist empowerment was positively related to value co-creation intention. Neither tourist-government interaction nor tourist-resident interaction had a direct relationship with value co-creation intention. Artificial intelligence technology stimuli moderated the paths from tourist-government interaction to tourist empowerment and from tourist-government interaction to value co-creation intention. No moderating effect was found for the tourist-resident interaction paths. The fuzzy-set qualitative comparative analysis identified multiple configurations associated with high value co-creation intention.

Leber hereditary optic neuropathy (LHON) is a mitochondrial optic neuropathy that typically causes severe bilateral central vision loss. Although several natural-history studies have reported visual outcomes, long-term trajectories beyond 5 years remain incompletely quantified, particularly in Asian cohorts. We performed a single-center retrospective cohort study at a tertiary eye hospital in Japan. Among 174 genetically confirmed LHON patients, we identified 27 patients (53 eyes) who presented within 6 months of onset and were followed continuously for ≥10 years. Best-corrected visual acuity (BCVA, logMAR) was collected from onset to 120 months. Piecewise linear mixed-effects models with patient- and eye-level random effects were fitted over three phases (Acute, < 12 months; Chronic, 12-60 months; Late Chronic, 60-120 months). Kaplan-Meier analyses estimated time to achieving BCVA ≤1.6 and ≤1.3 logMAR. BCVA worsened rapidly after onset, followed by gradual improvement and then an approximately horizontal course. During the Chronic phase, BCVA showed a small but statistically significant improvement (overall -0.030 logMAR/year, 95% confidence interval (CI) -0.045 to -0.015; -0.025 logMAR/year, 95% CI -0.044 to -0.007 in a pre-specified m.11778G > A subgroup). In the Late Chronic phase, estimated slopes were close to zero (+0.003 logMAR/year, 95% CI -0.007 to +0.013 overall), with wide CIs compatible with small long-term improvement or deterioration. By 10 years, the cumulative probabilities of achieving BCVA ≤1.6 and ≤1.3 logMAR were approximately 45% and 26%, respectively. In this Japanese LHON cohort with ≥10 years of continuous follow-up, BCVA showed limited improvement during the early chronic period, and we did not detect a clear directional trend thereafter. Given the modest sample size and selection of long-term attendees, these estimates should be interpreted as descriptive, phase-specific benchmarks rather than definitive evidence of long-term stability or ethnic differences.

Road traffic crashes pose a serious public safety challenge, particularly due to fatal and serious injuries. Although machine learning (ML) has been widely used for crash severity prediction, many studies remain accuracy-oriented and insufficiently address class imbalance, decision thresholds, and probabilistic reliability. This study proposes a safety-oriented and explainable ML framework for predicting killed or seriously injured (KSI) crashes using nationwide United Kingdom traffic accident data from 2020-2024. Crash severity is reformulated as a binary classification task distinguishing slight injury crashes from KSI outcomes, aligning model objectives with road safety priorities. A Light Gradient Boosting Machine (LightGBM) model is developed with imbalance handling using SMOTE, safety-oriented decision threshold optimization, and probability calibration. Model performance is evaluated using ROC-AUC, precision-recall analysis, confusion matrices, the Brier score, and a utility-based evaluation metric, while interpretability is ensured through SHapley Additive exPlanations (SHAP). Results show that default threshold settings fail to adequately detect severe crashes. At an optimized threshold of 0.35, the model achieves a Recall(KSI) of 0.605 - representing a substantial 73% improvement compared to conventional configurations - while maintaining acceptable precision. In addition, probability calibration confirms reliable risk estimation (Brier score = 0.190), supporting risk-based interpretation. Comparative analysis demonstrates that the SMOTE-based model provides a more balanced and operationally effective trade-off than class-weighted learning. SHAP analysis identifies speed limit, road class, lighting conditions, and urban context as key variables associated with KSI risk. The findings highlight the importance of safety-oriented learning design and context-aware performance interpretation for effective, risk-based traffic safety management.

This study aimed to develop a hydrogel-based co-culture system for pancreatic α- and β-cells to mimic native islet composition and achieve bidirectional blood glucose regulation. Monodisperse sodium alginate microsphere encapsulating α-TC6 and β-TC6 cells in a 2:8 ratio were fabricated using a microfluidic electrostatic spray platform. Key processing parameters (voltage, collection distance, flow rate, and alginate concentration) were optimized to precisely control microsphere diameter, yielding highly uniform spheres with excellent monodispersity. The alginate hydrogel exhibited favorable swelling properties and viscoelasticity, providing a supportive 3D microenvironment. In vitro, the microspheres demonstrated high biocompatibility, with cell viability exceeding 95% after 72 hours of co-culture. Encapsulation did not impair cellular function, as evidenced by unhindered insulin and glucagon secretion compared to unencapsulated controls, in streptozotocin-induced diabetic C57BL/6 mice, transplantation of these cell-laden microspheres into the subcutaneous brown fat significantly improved glucose homeostasis. Treated mice showed markedly better glucose tolerance during intraperitoneal glucose tolerance tests and maintained lower fasting blood glucose levels compared to sham-operated and unencapsulated cell transplantation groups. Furthermore, the treatment alleviated diabetes-associated weight loss, with the microsphere group showing a significant weight increase post-transplantation. Histological analysis confirmed the biocompatibility of the implants, with no significant pathological changes in major organs. In conclusion, this sodium alginate microsphere system effectively co-cultures functional islet cells, provides immunoisolation, and restores bidirectional glucose regulation in a diabetic mouse model, offering a promising strategy for pancreatic islet modeling and cell- based diabetes therapy.

Human papillomavirus (HPV) vaccination has emerged as the most effective method for preventing cervical cancer. Despite this, Ethiopia's HPV vaccine non-uptake rate remains high, with significant geographic variation, and there is limited evidence on the geospatial determinants of these inequities. This study aimed to map the geographic inequities in HPV vaccine non-uptake and identify its determinants among adolescent girls in Ethiopia. We conducted a secondary data analysis using the Ethiopian National Immunization Survey dataset. A stratified two-stage cluster sampling technique was used to select 467 enumeration areas (EAs) and a weighted sample of 5,341 adolescent girls. The geographic inequity of HPV vaccine non-uptake was analyzed using Moran's I, Getis-Ord Gi statistics, and Kriging interpolation in ArcGIS 10.8. We employed geographically weighted regression analysis to identify geographic factors associated with inequity in HPV vaccine non-uptake. Forty-six percent (46%, 95% CI: 44.7-47.8) of adolescent girls did not receive the HPV vaccine, and there were geographical variations in vaccine coverage. Higher proportions of HPV vaccine non-uptake were identified in eastern Amhara, eastern Oromia, central and northern Somali, central Afar, and the urban administrative units of Dire Dawa and Harari. Poor attitude and poor knowledge towards the HPV vaccine, not living with parents, and urban residence were predictors of geographic inequities in HPV vaccine non-uptake. The proportion of HPV vaccine non-uptake varied across Ethiopia, with geographic inequities identified in the eastern and northeastern parts of Ethiopia. Poor attitudes and knowledge about the vaccine, not living with parents, and urban residence contributed to these inequities. These findings highlight the need for targeted educational campaigns in areas with high non-uptake to improve knowledge and attitudes, alongside tailored strategies for regions where urban residence and not living with parents influence uptake.

The ISO 10993-5 recommends the cytotoxicity in vitro tests of the medical devices for the 2D cultures. The aim of the study was: - to develop the L929 cell cultures in the 3D model; - to adapt the above tests for the 3D L929 cell culture using the latex extracts; - to define how the model of the cell culture affect the response of the cells in terms of morphology, viability and the expression of Bax, Bcl2, Jkamp, Pidd1 and Cyp3a44 genes, and - to check whether this potential response depends on the cell age. To achieve these goals the optical and confocal microscopy, the LDH test and RT-qPCR technique were used. The L929 cells are relatively easy to culture in the 3D model The 103-105 cells/well were selected as optimal for the L929 spheroid formation. Generally, the 3D L929 cell cultures were less sensitive to the latex extracts than the 2D. The visible cytotoxic effects were noted regardless the age of cells, after 48 hrs. However, the spheroids of the older cells, after 72 hrs of exposure neutralized the cytotoxic effects and were regenerated. This effect was also confirmed in the LDH test and may be related to the high expression of the Bax gene.The expression of all analysed genes were changed in the 3D conditions. The cytotoxicity in vitro studies using the 3D model imposed certain limitations that are not present in the traditional model. Firstly, a limitation is the cell age, as the older L929 cells have been shown to be more sensitive to the cytotoxic agent. Secondly, for the older cells, a limitation may be the exposure time, given the potential for the spheroid regrowth.

Smoking is one of the modifiable risk factors of non-communicable diseases and cause of premature death. Surveillance is most often based on self-reported data among adolescents, but few studies have measured exhale breath using Carbon Monoxide in them. This study aimed to measure the prevalence of smoking by measuring exhaled Breath Carbon Monoxide Threshold Levels and Self-Reported Cigarette Smoking in a sample of in-school adolescents in Osun State Nigeria. The study employed a descriptive, cross sectional study design, a multi-stage sampling technique was used to select 616 adolescents from selected secondary schools in Osun State. Smoking status of adolescents were measured using Smokerlyzer, and WHO STEPwise questionnaire. The Cut-off point for current smokers using the exhale level of carbon monoxide (eBco) was ≥ 10parts per million. The collected data were entered into SPSS version 20 software for statistical analysis. Multivariable logistic regression analyses were done to identify the true effect of predictor variables on the outcome variable. Statistical significance was declared at a p-value < 0.05. Smoking by self- report was 80 (13.0%) while the smokerlyzer detected 168 (27.3%) current smokers. Cohen's κ = 0.063 (smokerlyzer) showed poor agreement between self-report and objective measures. Determinants of smoking include older age (AOR = 1.59, CI = 1.01-2.34), class level, compared with students in JSS1, SSS1 (AOR = 0.14, 95% CI: 0.07-0.26), and SSS2 (AOR = 0.46, 95% CI: 0.23-0.78) were significantly less likely to smoke. Rank regression analysis revealed that age was negatively associated with the rank of smoking status (B = -0.10, p = 0.008). Prevalence of smoking using smokerlyzer was higher compared to self-report among in-school adolescents. The study identified older age and class as important predictors of smoking Targeted health education should be done in schools to enhance smoking cessation.

Occupational exoskeletons show promise in reducing physical strain in industrial work, yet their industrial adoption remains limited. For exoskeletons to be used when performing tasks in industrial settings, they first need to be set up, then fitted and donned, and finally doffed, disassembled and stored for future use. Exoskeleton setup and takedown procedures can significantly impact industry deployment, adoption, and use, yet we have limited knowledge of the complexities in setup and takedown procedures and the resulting deployment barriers. The goals of this study were to understand how task complexity (number of task steps, usability problems and part count) in setup and takedown of exoskeletons impact task completion time and success, and present barriers in deployment. Twenty nine participants completed setup (assembly and donning) and takedown (doffing and disassembly) of four exoskeletons. We measured task times, success rates, task complexity (task step counts, part counts and usability problems). Hierarchical task analysis and heuristic assessments were performed to assess task complexity. Setup tasks, especially assembly, took the most time and exhibited the highest failure rates, whereas takedown tasks were faster and more successful. Participant-level regression analyses (N = 397 observations) showed that number of procedural steps was the strongest predictor, accounting for 66.9% of variance in completion times (β = 0.374, p < .001), with each additional step associated with approximately 22 seconds longer completion time. Usability problems also significantly predicted completion time (R² = 0.305, p < .001), while part count showed no significant association (p = .133). Our findings highlight that task complexity impact setup procedures significantly and can present a major deployment barrier. Moreover, our findings add new knowledge that number of steps, not part count, is the primary predictor of performance in setup procedures, and that usability problems differentially affect assembly and donning tasks.

There has been a drastic increase of pasteurellosis cases in Atlantic salmon aquaculture in Norway since 2018, caused by the bacterium Phocoenobacter atlanticus subsp. atlanticus, resulting in reduced animal welfare and increased mortalities. Early detection and identification of pathogens are crucial in intensive aquaculture to enable implementation of effective management and mitigation strategies. The increased application of environmental DNA (eDNA) monitoring in aquatic environments demonstrates the potential use for early detection of pathogens in aquaculture. In this study we investigated the usage of eDNA monitoring of Ph. atlanticus in Atlantic salmon aquaculture. We conducted a trial to investigate the effect of storage conditions and transport time on eDNA detection of Ph. atlanticus from water samples. We then conducted three field trials: a) to investigate the optimal sampling location for eDNA samples from farms with known Ph. atlanticus infection status, b) to screen farms presumed non-infected with Ph. atlanticus and c) to evaluate the eDNA detection in samples collected from anaesthetic tanks during lice counting. The storage trial revealed a reduction in Ph. atlanticus detection after one week at 4 °C or after two days at 22 °C. At farms with known Ph. atlanticus infection status we experienced poor detection of Ph. atlanticus from water samples collected in the net pen. However, samples collected from treatment water during thermal delousing revealed concentration of Ph. atlanticus during treatment, even in farms with negative net pen samples. Subsequent eDNA screening (sampling treatment water) of farms with presumed non-infected status, identified the presence of Ph. atlanticus in ~55% of the farms tested. Ph. atlanticus was also detected in water samples collected from anaesthetic tanks following lice counting. Our results demonstrate early detection of Ph. atlanticus, even in lowly prevalent populations, demonstrating the potential use of eDNA monitoring of pathogens in Atlantic salmon aquaculture.

Occupational diseases affect many workers in the United States, with Latinos disproportionately affected. Small businesses face barriers to implementing workplace health protections that community health workers (CHWs) may help overcome. The objective of this study was to determine whether a CHW-led industrial hygiene intervention could reduce volatile organic compound (VOC) exposure in small auto repair and beauty shops that primarily employ marginalized workers. In this two-arm, parallel, cluster randomized trial, small business (≤25 employees) auto repair and beauty shops in Tucson, AZ were randomized to immediate or delayed intervention, stratified by sector. CHWs assessed shops and provided knowledge of controls and $300 for new ones. Total VOCs (TVOCs) were measured using photoionization detectors placed on or near participants. The primary outcome was the change in TVOCs at the shop level after the intervention, assessed across three timepoints with four workshift measurements per assessment. Mixed-effects models accounted for clustering by shop. We enrolled 38 auto repair shops and 46 beauty shops (73% Latino workers) and analyzed 846 workshift measurements at 236 shop assessments. Adjusted models showed a non-statistically significant intervention effect: auto shops experienced on average an estimated 28% TVOC increase (95% CI: -46% to 203%); beauty shops experienced on average an estimated 27% reduction (95% CI: -55% to 19%). Beauty shops had TVOC concentrations about 10 times higher than auto shops, and 87% of their assessments had ventilation rates below the recommended minimum. Although not statistically significant, the CHW-led intervention may meaningfully reduce VOC exposure in beauty shops. High TVOC concentrations and inadequate ventilation in beauty shops highlight the need for targeted interventions and policy changes to improve the air quality in these underserved small businesses. This trial was registered with clinicaltrials.gov (NCT03455530) on March 6, 2018.